Combining limb-sparing surgery with radiation therapy in high-grade soft tissue sarcoma of extremities – Is it effective?

Müller, Daniel; Beltrami, Giovanni; Scoccianti, Guido; Frenos, Filippo; Capanna, Rodolfo

doi:10.1016/j.ejso.2016.02.004

Cited by 23 publications

(18 citation statements)

References 26 publications

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“…Other groups reported on complication rates in mixed patient cohorts, including cases with and without vascularised reconstruction, but did not separately describe morbidity for the different subsets of patients. Here, complications were observed in 6–35% of the patients . However, these studies suggested that flap reconstruction might help to reduce complication rates because the highest number of complications was found with the least number of flaps performed (9%) .…”

Section: Complications Of Radiotherapy With Free Flaps Compared To Prmentioning

confidence: 88%

“…Additionally, different types of complications are reported. These include persistent pain, oedema, fibrosis, pathological fracture, joint stiffness, osteoradionecrosis, osteomyelitis, chronic radiation dermatitis and wound‐related complications . The timing of radiation therapy mostly influences wound‐related complications, such as wound healing disorders, infection, seroma or haematoma.…”

Section: Timing Of Radiotherapy After Sts Resectionmentioning

confidence: 99%

“…These include persistent pain, oedema, fibrosis, pathological fracture, joint stiffness, osteoradionecrosis, osteomyelitis, chronic radiation dermatitis and wound-related complications. [22][23][24][25] The timing of radiation therapy mostly influences wound-related complications, such as wound healing disorders, infection, seroma or haematoma. The other complications are probably not related to radiation or the timing of radiation.…”

Section: Timing Of Radiotherapy After Sts Resectionmentioning

confidence: 99%

“…Here, complications were observed in 6-35% of the patients. 23,25,28,49,50,54,55 However, these studies suggested that flap reconstruction might help to reduce complication rates because the highest number of complications was found with the least number of flaps performed (9%). 25 With the exception of two studies, 54,55 it was found that the higher the percentage of flaps used, the lower the incidence of complications as shown in Table 3.…”

Section: Complications Of Radiotherapy With Free Flaps Compared To mentioning

confidence: 99%

“…25 With the exception of two studies, 54,55 it was found that the higher the percentage of flaps used, the lower the incidence of complications as shown in Table 3. 23,25,28,49,50 Radiation therapy is not the only factor influencing wound healing in STS patients. Other treatment options in multimodal regimens such as chemotherapy or ILP may likewise lead to increased morbidity rates.…”

Section: Complications Of Radiotherapy With Free Flaps Compared To mentioning

confidence: 99%

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Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Abouarab

Salem

Degheidy

et al. 2017

International Wound Journal

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Soft tissue sarcomas occur most commonly in the lower and upper extremities. The standard treatment is limb salvage surgery combined with radiotherapy. Postoperative radiotherapy is associated with wound complications. This systematic review aims to summarise the available evidence and review the literature of the last 10 years regarding postoperative wound complications in patients who had limb salvage surgical excision followed by direct closure vs flap coverage together with postoperative radiotherapy and to define the optimal timeframe for adjuvant radiotherapy after soft tissue sarcomas resection and flap reconstruction. A literature search was performed using PubMed. The following keywords were searched: limb salvage, limb‐sparing, flaps, radiation therapy, radiation, irradiation, adjuvant radiotherapy, postoperative radiotherapy, radiation effects, wound healing, surgical wound infection, surgical wound dehiscence, wound healing, soft tissue sarcoma and neoplasms. In total, 1045 papers were retrieved. Thirty‐seven articles were finally selected after screening of abstracts and applying dates and language filters and inclusion and exclusion criteria. Plastic surgery provides a vast number of reconstructive flap procedures that are directly linked to decreasing wound complications, especially with the expectant postoperative radiotherapy. This adjuvant radiotherapy is better administered in the first 3–6 weeks after reconstruction to allow timely wound healing and avoid local recurrence.

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Section: Complications Of Radiotherapy With Free Flaps Compared To Prmentioning

confidence: 88%

Section: Timing Of Radiotherapy After Sts Resectionmentioning

confidence: 99%

Section: Timing Of Radiotherapy After Sts Resectionmentioning

confidence: 99%

Section: Complications Of Radiotherapy With Free Flaps Compared To mentioning

confidence: 99%

Section: Complications Of Radiotherapy With Free Flaps Compared To mentioning

confidence: 99%

See 3 more Smart Citations

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Abouarab

Salem

Degheidy

et al. 2017

International Wound Journal

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Surgical Margins in Soft Tissue Sarcoma

Schwarzkopf

Fujiwara

Healey

2021

Evidence‐Based Orthopedics

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Synovial sarcomas: A single surgeon experience of 130 cases

Andreani

Ipponi

Mani

et al. 2022

Journal of Surgical Oncology

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Background Synovial sarcoma is a rare malignant tumor that generally requires a multidisciplinary therapeutic approach. In this study we report the experience of a single surgeon, evaluating surgical and oncological outcomes of the cases he treated through his 30 years carrier. Methods We enrolled patients treated surgically between 1988 and 2018. Surgical and medical treatments, as well as surgical and oncological results, were investigated. Results One hundred and thirty cases were included. Surgical resection was carried out achieving wide margins in 90% of the cases. At their latest follow‐up, 76 patients were continuously disease free, 16 were no evidence of disease, and other 16 were alive with disease. Twenty cases were dead of disease and two dead of other causes. Twenty‐five patients (19%) had local recurrence of synovial sarcoma through their postoperative intercourse. Thirty‐seven patients (28%) were diagnosed with at least a metastasis during their follow‐up. The global survival of our population, at each patient's latest follow‐up, was 82%. Cases with tumor size above 5 cm had a significantly higher risk to develop metastasis (p = 0.002). Conclusions Synovial sarcoma is a threatening disease and represents a challenge for oncological physicians and surgeons. Early diagnosis and multidisciplinary approach are mandatory to limit the spread of synovial sarcomas, maximizing the effectiveness of surgery and the other treatments.

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Combining limb-sparing surgery with radiation therapy in high-grade soft tissue sarcoma of extremities – Is it effective?

Cited by 23 publications

References 26 publications

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Surgical Margins in Soft Tissue Sarcoma

Synovial sarcomas: A single surgeon experience of 130 cases

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